Department of Public Health and Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy.
J Affect Disord. 2013 Jul;149(1-3):84-92. doi: 10.1016/j.jad.2013.01.007. Epub 2013 Apr 24.
The objective was to estimate the rate of subjects who tested positive at a screening for bipolar disorders among the people insured by a French Health Company, and subsequently to measure treatment patterns.
Cross-sectional postal survey on the "Mutuelle Générale de l'Education Nationale" (MGEN) policyholders. A self-rated questionnaire was sent by mail to 20,099 individuals randomly selected among MGEN policyholders. Tools: questionnaire on socio-demographic variables and health-care use; Mood Disorder Questionnaire (MDQ); Composite International Diagnostic Interview Short Form Self-Administered (CIDI-SA).
Responders were 10,288 (53%). The prevalence of MDQ positivity (MDQ(+)) was 3.6%. The respondents older than 65 showed the lowest frequencies. High frequencies were recorded by the people who had left work because of long term sickness and by people with invalidity. Subjects having a diagnosis of ICD-10 major depression were found to be at risk. Positive subjects had no more contacts with general practitioners than negative subjects; on the contrary they had more contacts with psychiatrists, alternative medicine professionals, psychologists, psychoanalysts, spiritual guides or welfare workers. MDQ+ subjects had a higher risk to use all kinds of psychodrugs, including antidepressants (27.7%, OR=2.7, CI95% 1.9-3.9).
The prevalence of MDQ(+) was similar to the surveys in the USA and Italy. The use of ADs in people with MDQ(+) and MDD diagnosis needs to be taken into account when managing the public health-care system. A large rate of positive subjects reported to have used ineffective treatments for bipolar disorders.
Relative low response rate and observational design.
目的是估计在一家法国健康保险公司承保的人群中，通过筛查双相情感障碍而检测呈阳性的患者的比例，并随后衡量治疗模式。
对“Mutuelle Générale de l'Education Nationale”（MGEN）被保险人进行横断面邮寄调查。向 MGEN 被保险人中随机选择的 20099 人邮寄自我评估问卷。工具：社会人口统计学变量和医疗保健使用问卷；心境障碍问卷（MDQ）；综合国际诊断访谈短表自我管理（CIDI-SA）。
回应者为 10288 人（53%）。MDQ 阳性（MDQ（+））的患病率为 3.6%。年龄大于 65 岁的受访者频率最低。因病长期缺勤和残疾而离职的人群频率较高。患有 ICD-10 重性抑郁症诊断的患者被认为存在风险。阳性患者与阴性患者相比与全科医生的接触没有更多；相反，他们与精神科医生、替代医学专业人员、心理学家、心理分析师、精神导师或福利工作者的接触更多。MDQ+患者使用各种精神药物（包括抗抑郁药）的风险更高（27.7%，OR=2.7，95%CI1.9-3.9）。
MDQ（+）的患病率与美国和意大利的调查相似。在管理公共医疗保健系统时，需要考虑 MDQ（+）和 MDD 诊断患者使用 AD 的情况。很大比例的阳性患者报告使用了无效的双相情感障碍治疗方法。
相对较低的回应率和观察性设计。
